title: Local recurrence after partial mastectomy: relation to initial surgical margins.
abstract: BACKGROUND
  Local recurrence (LR) after partial mastectomy (PM) has been associated with inadequate surgical margins. We assessed LR association with initial margins after PM in patients receiving postoperative radiation therapy (RT).
  
  
  METHODS
  Initial margins, re-excision status, and ipsilateral LR were identified for all patients having initial PM from 2003 to 2008.
  
  
  RESULTS
  Seven hundred twelve patients underwent PM as their final procedure, and 598 (84.0%) had adjuvant RT. Initial margins were positive or <1-mm margins in 166 patients (27.8%). Re-excision was performed for all positive and 20.2% of patients with margins <1 mm. We observed 10 LRs (1.7%) at the 3.4-year mean follow-up. For patients with initial margins <1 mm, the LR rate was 4.2% (7/167) and just .7% for margins ≥1 mm (P = .006).
  
  
  CONCLUSIONS
  We report lower LR rates than traditionally reported. The surgical practice of re-excision to achieve margins of 1 to 5 mm needs closer scrutiny because it may have no impact on LR.
authors.affiliation: Richard J. Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI 49503, USA. mccahill@trinity-health.org
authors.forename: Laurence E
authors.initials: LE
authors.lastname: McCahill
authors.forename: Richard
authors.initials: R
authors.lastname: Single
authors.forename: John
authors.initials: J
authors.lastname: Ratliff
authors.forename: Johanna
authors.initials: J
authors.lastname: Sheehey-Jones
authors.forename: Ann
authors.initials: A
authors.lastname: Gray
authors.forename: Ted
authors.initials: T
authors.lastname: James
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000473:pathology / Q000601:surgery; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D016896:Treatment Outcome